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'Talking' pilot to improve NHS culture


Nurses, doctors and other healthcare professionals could be expected to hold monthly sessions to discuss the pressures they face as part of a government backed initiative to improve culture and compassion across the NHS, Nursing Times can reveal.

Health minister Dan Poulter told Nursing Times the government was investing £650,000 to expand a pilot of what are known as Schwartz Center Rounds to an extra 40 hospitals over the next two years.

Schwartz rounds originated in the US where they were developed by the Schwartz Center for Compassionate Healthcare in Boston. They involve staff meeting once a month to discuss either specific patient cases or a set of circumstances they may face, such as caring for patients with dementia.

Research suggests this leads to staff feeling less isolated and better able to cope with pressures as well as improvements in communication.

They were introduced to the UK by the King’s Fund’s Point of Care Foundation and are currently used by 15 trusts around the country.

The practice was highlighted by Robert Francis QC in his Report of the Mid Staffordshire Foundation Trust Public Inquiry as a method of building a team identity between nursing staff on the wards and surgical and medical staff.

The roll out will take place over the next two years. Dr Poulter told Nursing Times the government wanted to see how they worked in different care settings before deciding whether to go further.

 He said: “I certainly know, as a doctor, the impact on the whole team of getting together and talking frankly about experiences and where things have gone well and not so well.

“After a very serious incident on a ward staff will have a de-brief about what happened but what we need is for this to be happening routinely where staff can discuss their concerns and they feel their contributions are valued and listened to.”

He said nurses and doctors “must find the time” for the rounds as the evidence was clear they had a beneficial impact on those who took part.

Organisations wishing to take part will have to pay a fee to the Point of Care Foundation which will deliver the project and train staff under license from the US-based Schwartz Center. Nursing Times understands the government cash will be used to kick start the national roll out.

Jocelyn Cornwell, director of the Point of Care Foundation, said: “There is a cultural problem at the heart of healthcare in this country which has been stubbornly persistent, despite the genuine efforts of healthcare professionals to make services more compassionate and sensitive to the needs of patients.

“The failings at Mid Staffordshire NHS Foundation trust were an extreme example of what can go wrong when there is a poor organisational culture.”

She said calls from organisations interested in Schwartz Rounds had increased to four or five a week following the publication of the Francis report.

The Royal Brompton and Harefield Foundation Trust was one of the first in England to adopt the idea.

Director of nursing and clinical governance Caroline Shuldham said she believed they were beneficial and should be expanded to other trusts.

She said: “All team members face challenges caring for patients and their families and it is good for nurses to engage with the whole multi-disciplinary team where they can explore the psychological, social and emotional aspects of caring in a safe and confidential environment.

“There is a suggestion that it has an impact on culture but I don’t think we truly know yet.”


What do you think?

We will be hosting a twit chat on Schwartz rounding at 1pm on Wednesday 29 May. To join in, follow #NTtwitchat and include this hastag in all your tweets.


Readers' comments (72)

  • What with clinical supervision, management supervision, meetings and training there really is no time for patient care. Its enough to turn you into a swivel eyed loon.

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  • Well, that's nice.

    Still no money or committment for adequate staffing levels and skill/mix ratios, or any 'initiatives' to deal with the serious, underlying and ignored real issues which are behind poor care and staff burnout then?

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  • There has been an "evaluation" by the Kings Fund (who originally piloted this) which has basically concluded that talking about things helps staff! No sh*t Sherlock! Where is the properly researched evidence that this has a direct impact on staff wellbeing and patient care? Seems to me that this is a cheap attempt by the government to put a plaster over a huge gaping wound. Yet another daft scheme introduced by a persistently blind and ignorant Health Minister who hasn't the foggiest idea of what is wrong with the NHS. Or how to fix it.

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  • nurses and doctors 'must find time' to attend these rounds, really, I thought it more important that I 'must find time' to look after my patients properly.

    the fee that will have to be paid, how much is it and who will benefit?

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  • a feasibility study is required to determine how many extra staff will be needed to attend these meetings!

    generous funding is provided to recruit new and specialised admin. staff to carry out this study.
    those interested please apply for this attractive post which offers very generous incentives, fringe benefits and a bonus to be paid out at the successful completion of the study if it is able to demonstrate that no more front line staff are required!

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  • tinkerbell

    no more of this kind of thing, let nurses nurse. We don't need you organising we can do this ourselves, f**k you very much.

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  • there are some people who should be piloted straight out the window!

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  • Wow, what a lot of negativity. Schwarz Center Rounds are a great idea for any number of reasons and have been demonstrated to significantly reduce stress levels, because believe it or not, simply talking things out in a constructive environment helps a lot. And they don't take away from patient contact time, they're typically run during lunch times with some food provided gratis as an incentive for attending. If you want to see how better staff support translates into patient experience go read the KCL NNRU Policy+ #39. I'd rather have a commitment to better staffing levels too but you don't need to spit in the government's face every time they offer anything else.

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  • tinkerbell

    no not a lot of negativity rather a lot of reality which these current shisters know nothing about. Give us the tools and we'll do the job and then some but we need to start with the basics and we haven't even got that sorted yet.

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  • Anonymous | 25-May-2013 3:40 pm

    Wow. What a lot of old sh*t?! Evidence please of measurable outcomes. HOW has it been demonstrated to "significantly reduce stress levels" amongst staff and HOW has this contributed to better staff wellbeing?

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